Investigation and determination of the needs and expectations of patients and general practitioners to optimise an eHealth intervention for antidepressant cessation.

Australia has one of the world’s highest antidepressant prescribing rates, placing a significant and unnecessary economic burden on both individuals and the healthcare system with a total cost of over $200 million per year.

Australian Rotary Health/The Kaiyu Funding Partner PhD Scholarship recipient, Amy Coe explored the factors that support both patients and GPs in engaging with antidepressant deprescribing in general practice.

Antidepressants are often a highly effective treatment for depression, with clinical guidelines typically recommending that treatment continue for 12 months following remission of symptoms. However, research suggests that up to one in three primary care patients remain on antidepressant medication well beyond this period, despite no ongoing clinical need. This prolonged use appears to be partly due to a lack of structured guidance and support for both patients and general practitioners on how to safely and effectively discontinue treatment.

The key findings include:

• GPs and patients are not routinely engaging in medication reviews; therefore, patients are not being identified for antidepressant deprescribing.
• Deprescribing discussions need to be initiated by a trusted professional – either a GP or, in the context of this study, a member of the research team.
• A personalised tapering plan is necessary to support individuals in beginning the deprescribing process.
• Ongoing coaching throughout the tapering period is important. It enables individuals to adjust their plan if needed and provides reassurance and validation in response to withdrawal symptoms.
• The ability to track mental health during tapering serves as a useful tool for self-reflection and supports emotional wellbeing.
• A sense of safety during the deprescribing journey is essential and is fostered through a combination of coaching support and reflective self-monitoring.

This research found that many individuals are willing to discontinue their antidepressant medication when they feel well, and often attempt to do so independently, without clinical support. However, identifying and targeting appropriate candidates for antidepressant deprescribing rarely occurs in routine clinical practice – this is a necessary first step in initiating the deprescribing process, and participants generally respond positively when identified and approached.

The study also demonstrated that clinical support and ongoing monitoring are essential throughout the deprescribing journey. Notably, this support does not need to be provided exclusively by doctors – other healthcare professionals, such as nurses, can be trained to deliver effective assistance. Moving beyond simply identifying barriers and facilitators, this research examined specific mechanisms that motivate patients and contribute to their success in safely ceasing unnecessary antidepressant use. Ultimately, the study highlights the importance of shared decision-making between healthcare providers and patients, with a strong emphasis on understanding and respecting patient preferences and priorities throughout both the prescribing and deprescribing process.

Media contact: [email protected]       First published 22nd July 2025

Graphic acknowledgement: FreePik.com